Provider Demographics
NPI:1942473806
Name:EKBERG, STEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEN
Middle Name:
Last Name:EKBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3480 KEITH BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-5568
Mailing Address - Country:US
Mailing Address - Phone:678-638-0898
Mailing Address - Fax:
Practice Address - Street 1:3480 KEITH BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5568
Practice Address - Country:US
Practice Address - Phone:678-638-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor